- there is a peculiar pattern of reflex preservation:
- **Loss of reflexes (lower motor sing) with up-going Babinski reflex. (upper motor sign)**
[!TIP] Mnemonic: Seeing gum hyperplasia should make you PANiC
Panic if you see gum hyperplasia
- Phenytoin
- AML <- "rapidly forming gingival hyperplasia is usually the first sign of this disease" Source
- Nifedipine
- Ciclosporin
Current standard chemotherapy regimens cure only a minority of patients with AML.
Source
Most young patients should be considered for allogenic stem cell transplantation.
Note: Dead space is NOT a cause for hypoxaemia
: DH-DLS
| purpura - | purpura + (with normal PLT count) | purpura - | purpura of lower extremities |
joint involvement can be monoarticular, oligoarticular (upto 4) and polyarticular (≥5).
Z line deformity
Constitutional:
Skin
Hands
Rheumatoid lung disease: mnemonic: affects all parts of the lungs
Cardiac: pericarditis is the commonest.
Sjogren syndrome: this is defined as presence of xerostomia or keratoconjuntivitis sicca in the presence of another connective tissue disease.
haematological:
Cauda equina is composed for 18 nerve roots. 2 or more are involved -> called cauda equina syndrome.
[!INFO] Compare with Conus medullaris syndrome:
- Conus medullaris: sudden onset, upper and lower motor symptoms present.
- knee jerk is preserved.
- less severe radicular pain.
- peri anal numbness ?not a dermatomal distribution
- impotence is more common than in cauda equina
- cauda equina can cause overflow incontinence in late stages but conus medullaris causes these in early diseases
Infective aetiologies of cauda equina
Features of cauda equina syndrome
[!INFO] Types of biomarkers
Don't confuse the different types of biomarkers used in MI.
[!INFO] Key points for exams:
- myoglobin is the first to rise
- CK-MB is useful to look for reinfarction as it returns to normal after 2-3 days (troponin T remains elevated for up to 10 days)
- Troponin levels rise within two to three hours of the onset of chest pain Source
The skeletal and cardiac isoforms of TnT (troponin T) and TnI (troponin I) are distinct. <- that's what's measured in MI.
cTnT = "cardiac troponin T"
skTnI = "skeletal troponin I"
Data suggest that brief periods of ischemia, sudden increases in preload, and physiological challenges like tachycardia and catecholamines can lead to the release of cTn.
4. Pulmonary embolism / pulmonary disease <- caused by right heart strain
Management: intravenous alpha1-antitrypsin protein concentrates + smoking cessation, supportive bronchodilators etc .
Source <- Dynamic air trapping in COPD.